Talk:Socialized medicine/Archive 3

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Question to right-wing American editors

When you use the term "socialized medicine", do you feel it is a pejorative or do you think it is an accurate description? If yes do you think the sentence in the lead "The term is often used in the U.S. as a pejorative..." has a left-wing bias? --Doopdoop (talk) 19:08, 28 February 2008 (UTC)

What, only right-wing American editors are allowed to respond to your question? What kind of consensus building is that? And, I'm sorry, but personal opinions of usage by Wikipedia editors, even in the multiple, constitute original research. --Sfmammamia (talk) 23:30, 28 February 2008 (UTC)
Sorry. Rephrasing the question- A question to ALL American editors - "When right-wing authors use the term "socialized medicine", do they think it is a pejorative or do these authors think it is an accurate description? If yes do you agree that the sentence in the lead "The term is often used in the U.S. as a pejorative..." has a left-wing bias? " --Doopdoop (talk) 00:37, 1 March 2008 (UTC)
How can the reader know what the author thinks? One can only second guess what the author is thinking! --Tom (talk) 08:31, 2 March 2008 (UTC)

lead sentence

The first sentence in the lead rewrite inserted by Kborer, which I have reverted twice, characterizes socialized medicine as "any health care system that embodies the fundamental principle of socialism, namely reduced individual liberty in favor of increased centralized control." I find this characterization of socialism highly biased and not in keeping with the definition contained in the Wikipedia article on socialism, in which the primary goal is defined in the lead as "a socio-economic system in which property and the distribution of wealth are subject to control by the community." We should not be redefining socialism on this page. --Sfmammamia (talk) 21:15, 2 March 2008 (UTC)

You may not have noticed this, so I'll just politely point out that I put a reference in the article for the definition of socialism that I was using. Kborer (talk) 22:40, 2 March 2008 (UTC)
Kborer's lead sentence is hallucinatory. He fights over whether or not the term is pejorative, while attempting to introduce a definition that is several steps beyond POV and pejorative itself. Just keep reverting.--Gregalton (talk) 22:08, 2 March 2008 (UTC)
If you really think that there is a mistake then please point out what is factually incorrect. Encouraging people to revert rather than discuss is counter productive. Kborer (talk) 22:40, 2 March 2008 (UTC)
This is a non-mainstream definition using sources that are far less reliable than the ones used before. The definition of socialized medicine is not the same as that of socialism. And the use of an unusual definition of socialism is so biased it is absurd. Defining the "fundamental principle of socialism" as reduced liberty in favour of centralized control is in itself biased.
I am encouraging to revert here because you have undertaken edit warring with an inflammatory definition and no discussion. If you were even attempting to be NPOV, it may be worth discussing, but you have clearly decided to simply edit war.--Gregalton (talk) 06:50, 3 March 2008 (UTC)
In defense of my definition of socialism, here is a definition that is "main stream" Britannica..
You are right that socialized medicine and socialism are different. One is a health care system, one is an economic system.
There is nothing biased about defining the fundamental principle of socialism as decreased individual liberty in favor of increased centralized control. That is what the definitions say. You could rephrase it the way that Doopdoop did by replacing individual liberty with individual control, but they mean the same thing.
As far as edit warring, there are a number of editors who have been very liberal with their use wholesale reverts. I do not think that anyone has been abusing it lately, but I think there were a few cases earlier this year and last year where a certain editor was asked to make incremental changes so that they could be evaluated individually. When those changes were reverted all at once with no discussion, that was probably inappropriate.
Yes the definition is inflammatory, but it was not intended to be. I was merely trying to convey what socialized medicine is in a clear and succinct manner. So your conclusion is incorrect, and I hope you will consider discussing the changes. Kborer (talk) 23:39, 3 March 2008 (UTC)
Britannica uses the phrase "social control"; Wikipedia uses the phrase "community control". Either of these is acceptable -- "centralized control" -- is not. I believe it would be neutral and acceptable to define socialized medicine as a broad term that encompasses all systems that subject health care to "social control" or "community control" rather than individual control or the free market. Beyond that, saying that different words for something "mean the same thing" is where you get into trouble and very quickly show your bias. --Sfmammamia (talk) 00:39, 4 March 2008 (UTC)
When I say individual liberty and individual control mean the same thing, I mean that they literally mean the same thing, as the definition of liberty is the "condition of being free from restriction or control." I think "social control" is less clear than centralized control or government control or centralized government control. Also, "socialized control" has another meaning. which might be confusing. Kborer (talk) 01:05, 4 March 2008 (UTC)
You may think that "social control" is less clear, but I disagree. So where does that leave us? "Social control" is a more neutral phrase, which is why Britannica uses it. Words have connotations, which is why they must be chosen with care. "Liberty" is another word that carries heavy connotations. Also, "social control" has the benefit of being credibly sourced. No one is recommending "socialized control". May I remind again you that the goal is consensus? --Sfmammamia (talk) 04:58, 4 March 2008 (UTC)

I meant to say above that social control has another meaning, which makes it a somewhat confusing euphemism. I do not see how the word liberty has any connotations other than it's definition. Kborer (talk) 00:43, 11 March 2008 (UTC)

Well, let's see, the first definition of liberty here is: "freedom from arbitrary or despotic government or control." Kborer, if you insist that two words are "the same" in meaning, why can you not accept the alternate term if someone else objects to your chosen word or phrase? That's the nature of the consensus process. --Sfmammamia (talk) 01:31, 11 March 2008 (UTC)
I don't mind interchanging government control and centralized control as they are very similar. I said before that social control is intended to be a synonym, but might be confusing, so I prefer not to use it. For my last merge, in place of individual liberty I tried "free market approach". If there is a better term, I don't mind changing it again. Kborer (talk) 01:35, 11 March 2008 (UTC)
There is no consensus that socialized medicine is necessarily "centralized control". Nor have you supplied a reliable source to support that claim. Even if you could supply a reliable source, it would only be one POV, and we would have to give others.

There is no consensus for any of the definitions. Centralized control and government control are synonymous. We have definitions that say that socialized medicine is a health care system controlled by the government. This is the same thing as saying that socialized medicine is a health care system that is centrally controlled. Kborer (talk) 00:43, 11 March 2008 (UTC)

Once again, you've misused the source and left out important parts: (Dorlands)"a system of medical care regulated and controlled by the government, in which the government assumes responsibility for providing for the health needs and hospital care of the entire population, at no direct cost or at a nominal fee to the individual, by means of subsidies obtained by taxation." This does not say that regulation and control are the defining feature, nor sufficient to call a system socialized. This definition includes the concepts of universality and government financing, as well as provision at little or no cost. These are not "optional" components under the Dorland's definition.--Gregalton (talk) 07:50, 11 March 2008 (UTC)
(It's not an objective, universally acknowledged fact that socialism is centralized control. Emma Goldman was an anarchist socialist who didn't believe in centralized control. Giving up some liberty isn't a unique characteristic of socialism, it's a characteristic of any form of social organization.)

The point is not that it is a characteristic. The point is that it is the dominant characteristic. If the government is involved a little bit, it is not considered socialized medicine. If the government deeply integrated, then it is socialized medicine. Kborer (talk) 00:43, 11 March 2008 (UTC)

Blogs are not reliable sources. Nor are partisan think tanks. The Encyclopedia Britainnica is a reliable source, but it doesn't say "centralized control." The definition cited merely says:
"system of social organization in which property and the distribution of income are subject to social control rather than individual determination or market forces."
Nothing about central control. So your own sources argue against using "centralized control."

Social control is a euphemism for centralized control in that context. That should be obvious from the actual definition of social control. This source, among most of the others, supports the notion of centralized control as the key aspect of socialized medicine. This makes sense because socialized medicine is just a health care system done in a manner consistent with socialism, and socialism is all about central control. Kborer (talk) 00:43, 11 March 2008 (UTC)

You can have systems that could reasonably be called socialized medicine without central control. For example, there are national systems which place much or most of the control on the province level.

A province is still a centralized location. That like saying that if the UN provided health care, but most of the control was given to the governments of individual countries, then it is not centralized control. It is still far removed from the individual. Kborer (talk) 00:43, 11 March 2008 (UTC)

Calling it central control is original research, or unsupported opinion, or both. Unless you can support it according to WP rules, it has to go. That's independent of whether it's a value judgment. Nbauman (talk) 06:19, 4 March 2008 (UTC)

It is not original research. For example, the very first reference on the page, (which is again being misapplied to an incorrect definition of socialized medicine) says "a system of medical care regulated and controlled by the government". If the government is controlling it, that is centralized by definition. Kborer (talk) 00:43, 11 March 2008 (UTC)


This version of the first sentence ("Socialized medicine is any health care system that embodies the principle of socialism,[1] [2] namely centralized community control") is not biased. Do you agree? What are the other issues that cause you to revert Kborer's version? --Doopdoop (talk) 22:48, 2 March 2008 (UTC)

The cites are from clearly critical websites and opinion pieces at that. The lead on an article should concentrate on defining and describing the subject, not demolishing it. By all means use these cites appropriately later in the article, but they shouldn't be leading it. --Escape Orbit (Talk) 00:29, 3 March 2008 (UTC)
How exactly does the opening sentence demolish socialized medicine? Kborer (talk) 03:28, 3 March 2008 (UTC)
Biased - imagine if it said "embodying the principle of socialism, enhancing the liberty of the individual in the face of control by capitalist medical monopolies?". This article is not about socialism. The sources used are not reliable (certainly not compared to those that were in the lead). I believe Escape Orbit meant that the lead sentence above is so biased that only those who favour reduced liberty and centralized control (presumably not many, the language is so biased) would continue to read on.
Can you honestly not see why others would see this as biased?--Gregalton (talk) 06:56, 3 March 2008 (UTC)
Merely stating who gets to make decisions in the system is not biased. Implying that one way or the other is better or worse is biased. The newer version does not make a value judgment.
If you have a problem with any particular reference, then please point it out. There are a number of them and all of the ones from the older version are included the new version.
If the topic is repulsive by its very nature, then there is nothing that can be done. If there is more accurate way to to describe it, then we should certainly move towards that. Kborer (talk) 00:05, 4 March 2008 (UTC)
If I could find an opinion piece from a left-wing website that described "Socialized medicine" as bees-knees, and the ultimate indication of a civilised society, would it be ok for me to change the definition in the lead sentence accordingly, using it as a cite? No, of course it wouldn't. The lead in any article should strive to be as neutral as possible, particularly on controversial subjects, leaving criticism or praise to suitably balanced sections further down. --Escape Orbit (Talk) 09:17, 3 March 2008 (UTC)
That is a value judgement, so it would not be NPOV. As I stated above, there is no value judgment in stating that socialism and socialized medicine are about centralized control. Kborer (talk) 00:05, 4 March 2008 (UTC)

I have reverted the recent changes which attempt push bias, POV, and guilt by association into the lead sentence. I have the clear sense that most editors here do not accept the changes that have been inserted by --Doopdoop and Kborer which have been previously reverted. My own reversion is not without precendent and needs no further explanation. --Tom (talk) 07:12, 4 March 2008 (UTC)

Some editors would prefer the version you reverted to, but unfortunately it is too flawed to be acceptable. It is misleading in both fact and in its misuse of references. It defines socialized medicine as a derogatory synonym for publicly funded health care, which is not true according to the very definitions that are used to support that claim! Kborer (talk) 02:19, 5 March 2008 (UTC)
Most of the above attempts to justify this version of the lead seem to be discussion of the meaning of socialism, liberty, central control, and has little to do with this topic. There is no reason to get into this in the opening sentence.
There is no discussion of the meaning of anything besides socialized medicine. Explaining that socialized medicine is medicine done in a socialized way, and then explaining what that means is not off topic in the least. Kborer (talk) 02:19, 5 March 2008 (UTC)
And I find the defence of "inflammatory, but not intentionally so" a bit of a stretch, particularly when this had been pointed out by editors.--Gregalton (talk) 07:20, 4 March 2008 (UTC)
If an editor writes something that is true, and it evokes strong emotions from other editors then it is inflammatory. That does not mean there is anything wrong with it. Kborer (talk) 02:19, 5 March 2008 (UTC)
The edit histories also allege that the (more or less) stable version is misreferenced and missourced. Please provide details.--Gregalton (talk) 09:52, 4 March 2008 (UTC)
The opening claim is that socialized medicine is 1) a term 2) synonymous with publicly funded health care 3) that is derogatory. However, of the first reference "supporting" it: [1] says that it is 1) a system 2) that in addition to being publicly funded is controlled by the government 3) and does not say that it is pejorative. In fact, most of the definitions cited in the article make do not say that it is pejorative, and also say that it is a system. Kborer (talk) 02:19, 5 March 2008 (UTC)
I'm agreement with Tom. The redefinition of the term in the lead sentence is entirely reliant on a definitions from opinion pieces on biased websites. As I've said before, opening sections should always strive to be neutral. This clearly isn't and establishes a unbalanced tone from the offset. The references provided also don't quite say what the cites claims they say, and the combination of them sails very close to original synthesis, particularly the irrelevant introduction of a cite for a definition of socialism. --Escape Orbit (Talk) 11:00, 4 March 2008 (UTC)
You decry the references used by the newer version, yet the first reference used in the old version directly contradicts every aspect of the claimed definition. You say the new version is not neutral, yet the old definition completely ignores referenced definitions in favor of implying that "socialized medicine" is just some dirty term that is not even worth talking about.
In the new version, there is no synthesis of ideas. Socialism is centralized control. Socialized medicine is centralized control of medicine. Stating that socialized medicine is a health care system implemented in a socialized way is not anywhere close to a new idea. It is merely describing socialized medicine in the context of socialism in order to make it easier to understand. Kborer (talk) 02:19, 5 March 2008 (UTC)
Once again, there's no consensus on usage of the term "centralized control". --Sfmammamia (talk) 06:14, 5 March 2008 (UTC)
Once again, there is no consensus on any of the definitions. Kborer (talk) 03:44, 9 March 2008 (UTC)
In response to kborer on the sources: the sources provided cover both a) term and b) pejorative. You may have moved sources down in the article before and now:
  1. Paul Wasserman, Don Hausrath, Weasel Words: The Dictionary of American Doublespeak, p. 60: "One of the terms to denigrate and attack any system under which complete medical aid would be provided to every citizen through public funding."
  2. Edward Conrad Smith, New Dictionary of American Politics, p. 350: "A somewhat loose term applied to..."
  3. "Dirty Words", Winston-Salem Journal, December 14, 2007, "Jonathan Oberlander, a professor of health policy at UNC Chapel Hill, explained that the term itself has no meaning. There is no definition of socialized medicine. It originated with an American Medical Association campaign against government-provided health care a century ago and has been used recently to describe even private-sector initiatives such as HMOs." See also Socialized Medicine Belittled on Campaign Trail, National Public Radio, Morning Edition, December 6, 2007: "The term socialized medicine, technically, to most health policy analysts, actually doesn't mean anything at all," says Jonathan Oberlander, a professor of health policy at the University of North Carolina."
  4. [http://www.npr.org/templates/story/story.php?storyId=16962482 "In the debate over health care on the campaign trail, the term "socialized medicine" is getting thrown around more and more often. It is almost never a compliment. But the politically loaded phrase means different things to different people."
As noted before in this talk page, saying that it is "a system" when the definitions of what system it is contradict each other is the reason to use "it is a term used to describe."
This new version is, IMO, terrible, even after the compromise version. "Social control" is loaded and most of the definitions do not say anything like this. An example of the specific definition "A system of health care in which all health personnel and health facilities, including doctors and hospitals, work for the government and draw salaries from the government" has also been relegated to later in the article, and I see no reason to prefer the other definitions over this one.--Gregalton (talk) 07:43, 5 March 2008 (UTC)
The first reference is rather weak, as the author has a large incentive to use definitions of words that fit his agenda. Your second reference is clearly wrong, as definitions have been provided above. The first NPR reference says that it does not mean anything to health care analysts. That is fine, but it does not mean that the socialized medicine is meaningless to other people -- for example economists. The second NPR reference says that socialized medicine means different things to different people. That is obvious from the first NPR reference, and more relevant to the usage section than the definition.
There are no definitions in contradiction on what a health care system is. There are definitions that differ on implementation, but not on the fact that it is a health care system.
The broad definition was not given preference in the newer version. It merely said that some definitions go one way, and some go another. Kborer (talk) 03:44, 9 March 2008 (UTC)
You have alleged bias for one of the sources, claimed a dictionary is clearly wrong (when the point is that the term is "loose" because definitions used vary and contradict each other - the point of this). If you want an economist's version, we can go with Reinhardt, who is quoted as saying ""strictly speaking, the term 'socialized medicine' should be reserved for health systems in which the government operates the production of health care and provides its financing." The implication and the article make it clear that the term is not used strictly, contradicting the other uses of the term. Your revert to a much-earlier version has also removed the other corrections and issues fixed previously.--Gregalton (talk) 07:40, 9 March 2008 (UTC)
My 'clearly wrong' comment was aimed at the "Dirty Words" reference. As you can see from your very own quote, Reinhardt says that socialized medicine is a system. Kborer (talk) 14:50, 9 March 2008 (UTC)
You are selectively reading the Reinhardt quote: he says the term should be reserved for a particular type of system; it is clear from the context that the term is not used in this sense alone. And his reference to the 'term' supports the usage of 'term' in the opening: the term is used to mean different things (outside the usage for which he believes it should be reserved).--Gregalton (talk) 09:43, 10 March 2008 (UTC)
If you read this Reinhart reference, he defines socialism as a government ownership. Other people define socialism as centralized control. The question is not what socialized medicine is. Socialized medicine is a health care system implemented in a manner consistent with socialism. The disagreement here is what constitutes socialism. Furthermore, Reinhardt admits to having little experience with the United States. This hardly makes him a more reliable source than dictionaries and encyclopedias for this particular argument. Kborer (talk) 00:43, 11 March 2008 (UTC)
You should check on background before making comments like this. He does not say he has little experience in the US; he says he "grew up" in other countries. Since he's been at Princeton since 1968 and a member of the Institute of Medicine of the National Academy of Sciences since 1978, I think his experience is likely sufficient by any measure.--Gregalton (talk) 07:26, 11 March 2008 (UTC)

Kborer seems to misunderstand how socialized systems work. My health care in Finland or in the UK is no more subject to "social control" than I assume his/hers is in the U.S. under private health care. If I get ill I see my doctor and he passes an opinion on what the problem may be or may call for more tests before he decides. I think that is pretty much common practise everywhere. When the results come back we discuss what this means and what the alternatives are. We choose the option that suits me and treatment begins. I have no idea where he thinks the social control comes into play. I'd be interested to know though. --Tom (talk) 12:51, 5 March 2008 (UTC)

I have no knowledge of your specific health care system. I did not claim that Finland has socialized medicine. There is not enough information in your first hand account for me to draw any conclusion, and I do not see how it is relevant. Kborer (talk) 03:44, 9 March 2008 (UTC)
Look into how doctors are paid... --Doopdoop (talk) 18:21, 5 March 2008 (UTC)
So you ARE Kborer! --Tom (talk) 16:17, 6 March 2008 (UTC)
Why do you think so? --Doopdoop (talk) 20:44, 6 March 2008 (UTC)
It was said tongue firmly in cheek! But doctors are paid very well in the UK and I'm sure the pay levels are comparable. (GP's in the UK I believe earn on average about US$200,000 per annum (this is AFTER deduction of business expenses like staff, accommodation etc..) In the US doctors have to finance their own way through medical school (which surely must excludes many poor people from ever becoming doctors). In the UK most general university course fees are subsidized by the government (I think the student pays about 1/3 the cost and the government the other 2/3. On top of this, the NHS pays bursuries to assist all medical students with both their living expenses and their medical course costs which over and above the help which non-medical students receive. See http://www.nhsstudentgrants.co.uk/ Thus, in the UK, most students do not leave college with as high a mountain of debt round their necks as happens in many other countries. Finland actually goes one better. Students get all their living costs paid for by the government AND all their course fees, so they start work with no debt whatsoever. I think many US medical students would be in awe at that!
But I digress. I think Kborer can answer the issue of "social control" himself. --Tom (talk) 16:25, 9 March 2008 (UTC)
I am not sure why this is directed at me. I am opposed to including this notion of social control in the article. Kborer (talk) 00:43, 11 March 2008 (UTC)
Well you added socialism which Britannica regards as social control so you introduced the notion but yes it was not you but rather Sfmammamia that preferred the actual term social control. The point is that in the countries I know that have this system of medicine my general practitioner may get re-imbursed or salaried by the government, but both my GP and my surgeon (as and when I go under the knife) and all the nursing staff are in practice actually working for me, not the government. This notion that the government is somehow interferring or "socially controlling" the delivery of my health care is complete nonsense for most practical purposes. And I am sure the same happens in the US. The medical and nursing staff may get paid by the owner of the hospital but the hospital owners are in no meaningful way controlling your health care. Your care is delivered by dedicated professionals whose number one aim is your welfare. And that is the same in both systems. --Tom (talk) 12:36, 11 March 2008 (UTC)
Actually, Tom (while this is somewhat off-topic), in the US, with the ubiquity of managed care, there's some degree of "centralized control" exercised by insurance companies. They decide what procedures are worth the cost. --Sfmammamia (talk) 14:44, 11 March 2008 (UTC)
Medicare and Medicaid both make coverage determinations too. EastTN (talk) 16:04, 11 March 2008 (UTC)
It may be off topic for this section of TALK , but perhaps not for the article. It maybe its worth adding a section to the article to how "value for money" decisions are made in deomcratized health care in socialized systems and compare it with value for money decicions made by private insurance companies, managed care organizations, and at the other extreme, pay-as-you-go medicine. This is perhaps a distinctive feature of socialized systems that is worth exploring.--Tom (talk) 07:24, 12 March 2008 (UTC)

Broad and Narrow definitions... and now a third?

We originally had one broad and one narrow definition set. Broad being any kind of medicine which is publicly financed and narrow which is public financed and publicly delivered. We now seem to have added a third. It does so at the point where it says

"Others assert that government regulation and control, where the government takes responsibility for providing health care for the entire population (at no direct cost or a nominal fee) constitutes socialized medicine" for which it cites the Dorland defintion.

I am not convinced that this third definition is really necessary. The Dorland definition is really restating the obvious; spending public money requires controls and regulation to ensure fair play for taxpayers. To me the same type of controls and regulations must exist in private insurance which requires controls and regulation to ensure fair play between policy holders with the same policy. Or have I missed something?

I think we should remove this third definition because it adds nothing and just muddies the previously clear broad and narrow definitions which I think gave greater clarity.

Your collective thoughts please.--Tom (talk) 16:38, 6 March 2008 (UTC)

I don't disagree that this one is not a third definition, although I would prefer it be integrated rather than removed. The Dorland was being used as an example of a very broad definition ("control" if I remember correctly), whereas the actual text is much more complete; effectively, Dorland is a definition of publicly-funded universal health care. I corrected its usage because (in my view) it misrepresented the source. Hence what has now come out as a "third" definition is really just another point in the mushy grey scale between broad and narrow, and yet another example of inconsistent usage.--Gregalton (talk) 16:46, 6 March 2008 (UTC)
I didn't mean the link to the definition, but just whether "control" or "regulation" by government is not a defining factor as nearly all countries governments regulate health care to some extent. And even ignoring this, all systems where there are scarse resources are controlled and regulated. Private health insurance is controlled and regulated by private insurers and their bureacrats (Sicko gave lots of examples). Free market medicine is controlled by the invisible forces of supply and demand. "Control" and "Regulation" are simply not defining features. Government ownership of the delivery system is what marks out the narrow from the broad definitions.
And as for practicality, one might think that because the government owns the health delivery system, it is the government that is doing the regulation. But the reality is quite different. The government effectively sub-contracts this job to the medical profession which largely self-regulates it in the form of collective wisdom arising from the consensus of experts on what works and what does not and what is cost effective and what isn't.--Tom (talk) 18:55, 6 March 2008 (UTC)
I'll reserve judgment on those issues. My specific point was that the use of the source did not accurately reflect the source.--Gregalton (talk) 19:50, 6 March 2008 (UTC)

To clarify:

  • Broad: Socialized medicine is where the government controls the health care industry.
  • Narrow: Socialized medicine is where the government owns the health care industry.

The other definitions mentioned are wrong. For example "Broad being any kind of medicine which is publicly financed" is the definition for single payer health care. "government regulation and control, where the government takes responsibility for providing health care for the entire population" is just the broad definition. Kborer (talk) 14:58, 9 March 2008 (UTC)

I don't think that you can refer to industry. In the UK (narrow) the government does not control the medical care "industry" as you call it. But it does deliver and finance huge parts of it. And in Canada (broad) the government does not control the health care industry either, but again it finances a large part of it. Hence we come back to government finance being the core factor and ownnership of the delivery system the difference between the broad and narrow definitions. The use of the term "Single payer" just muddies the water because this term is as badly thought out as "socialized medicine". Your definition would define the UK's NHS as Single payer (which logically it is because funding for it is central), although most people in the U.S. would, I think, draw a distinction and say that Single Payer is not Socialized medicine (and vice versa). Therefore I think the existing distinction between broad and narrow is correct. I would object strongly if you tried to alter this in line with your suggestion.
Single payer just means one source of funds. Single payer health insurance means the government pays bills and that is it. In the UK, is the government just paying the bills and that is it? No, they make lots of other health care decisions too. But in Canada, are they just paying the bills? Many would argue that is the case. Now say hypothetically that Canada wrote a list of instructions that told doctors how to do their job. They would still have private practices, but the government would have taken control of the health care system. My approach to explaining this is giving a high level explanation of what socialized medicine is, then explaining the broad and narrow definitions in more detail. I am not trying to remove the distinction, just to explain that they are similar. Kborer (talk) 01:01, 11 March 2008 (UTC)
Incidentally Kborer , how do you think Health care in The Netherlands should be described? The government funds only 5% and owns neither the hospitals nor the health insurance companies. Is this socialized medicine? If so, why? If not, why not? --Tom (talk) 15:56, 9 March 2008 (UTC)
Actually Tom, according to the WHO, the health care system in the Netherlands was 62% government funded. Here's my attempt to analyze the discussion so far. I'm listing the definitions provided in neutral references, and categorizing them according to the broad and narrow definitions we are discussing.
Broad -- common feature of these definitions is government funding ("subsidies" being the most common term)
American Heritage
Columbia Encyclopedia
Dorland's
Random House Unabridged Dictionary
Merriam Webster's
Narrow -- government employs doctors and runs hospitals
MedTerms
After looking through these carefully, I feel that a third definition -- that government regulation alone constitutes socialized medicine -- would probably come from only a highly biased source (free market libertarians) and therefore would probably fall under WP:UNDUE. We have plenty of neutral reliable references to support these two definitions as well as the general statement that usage varies. And I agree with Gregalton that Kborer's version, which used the Dorland definition to support this statement -- " heavy government regulation constitutes socialized medicine" -- is a distortion of what that source actually says. --Sfmammamia (talk) 17:41, 9 March 2008 (UTC)

The source says that socialized medicine is a system controlled and regulated and financed by the government. How exactly is the claim that socialized medicine is a system funded and heavily regulated by the government a distortion? Kborer (talk) 01:01, 11 March 2008 (UTC)

Because the word "heavy or "heavily" is nowhere in the source, and introduces bias into the defintion. Who's to say what constitutes "heavily regulated"? --Sfmammamia (talk) 01:23, 11 March 2008 (UTC)
I do not mind changing the term heavily to something else. It is merely to illustrate that the government is not just lightly involved, or involved in a small way. Rather, that it actually exerts a relatively large amount of control. Kborer (talk) 01:31, 11 March 2008 (UTC)
Sorry, but there's no way to neutrally define the degree of government involvement or control that is required for a health care system to fit the broad definition of socialized medicine. Actually, as I think Tom has pointed out on numerous occasions quite eloquently, there's no way for universal health care to be achieved without government involvement, and whether you think that's "heavy" or "light" depends completely on your point of view. Can you cite any system that fits the broad definition of socialized medicine where the government has little control or light involvement? It seems we are going in circles in these discussions, as I scan the talk page, it appears these same topics and debates came up in December. --Sfmammamia (talk) 01:53, 11 March 2008 (UTC)
Sfmammamia: re 62% (Netherlands data and WHO). Is the 62% WHO figure from before or after the 1 Jan 2007 health care reform? The dutch government video claims the new system is only 5% funded by government.--Tom (talk) 14:08, 10 March 2008 (UTC)
The WHO figure is a few years old (I think 2004 or 2005, the last year of common data in the WHOSIS database). I'd be interested in seeing the video you mention -- is it available online somewhere? --Sfmammamia (talk) 14:16, 10 March 2008 (UTC)
Click on this link to see the 8 minute video explaining the health care system. But be aware of this; the video sound track is in both English and Dutch but an English subtitle track is visible if the T symbol is clicked in the video control.--Tom (talk) 09:35, 11 March 2008 (UTC)
Yes, we've been through this before. Apart from citing any so-called "socialized" health care system where the government has little control or light involvement, it would be useful to identify any non-socialized systems where the government has "little control or light involvement." Depending on how tightly one wants to define control and involvement, it is probably only failed states or the least developed countries that would qualify.--Gregalton (talk) 07:31, 11 March 2008 (UTC)

RfC --- Article identity

Editors cannot even agree on a purpose for this article, much less the presentation of content. Help is needed in determining an acceptable structure for this article. The primary issues in contention are:

  • A) with multiple verifiable definitions, are any of them "mainstream" and are any of them insignificant enough to exclude;
  • B) is "socialized medicine" only a POV term that should be discussed only insofar as the connotations of the phrase, or is "socialized medicine" a system of health care;
  • C) if "socialized medicine" is indeed a POV term, then should the history of the system that it disparages be discussed anyways;
  • D) is "socialized medicine" functionally distinct from Publicly-funded health care in any significant way; and,
  • E) should the implementation section be included here or merged into another article.

In addition to input on the above topics, it would be helpful for editors to post their personal preference about the relative priority of the above issues. In order of importance, I would say the most important issue to be resolved is: B, then D, C, A, and finally E. BigK HeX (talk) 06:50, 20 February 2008 (UTC)

B, D, E, A, C. As a note, "disparages" in C is POV. Kborer (talk) 15:57, 22 February 2008 (UTC)
A, B, D, C, E. Not sure if this list of prioritization is particularly helpful, but you asked. I think the main focus needs to be the usage of the term - including the political connotations. This includes the various definitions. I think implementation is largely repeated elsewhere, but I recognize Tom's valid point that the issue will end up getting reinserted, so do not insist that implementation be addressed only in other articles.--Gregalton (talk) 08:32, 23 February 2008 (UTC)

A. Socialised medecine is a term that is used also outside the US, In France for example[citation needed]. It seems to me this is only the extreme of a Publicly-funded health care system, a system where health care are provided by the state as a public service. The English "National Health Service" looks very much like socialised medecine.
B. It is true the word socialism is everywhere more or less negatively connotated, so socialised medecine is also negative. A non negatively term would be rather "public medecine".
D. Yes, in publicly-funded system is a mix between a private system and a public system, a system where medecine is still private but some funding is public.
E. I think the article should be merged with "publicly-funded health care" into a new wiki page named "public health care systems", that would deal with all systems of health care that involves the state, whether these are systems of public funding or system of public medecine. In the critics about public systems, there would be a section about "socialised medecine", as an expression of hostility to public medecine.--Voui (talk) 21:38, 1 March 2008 (UTC)

You say it is used in France but you have not given us any example. The French use the word social derivations from social or derivations from it to mean "community" such as "médecine communitaire", community medicine. This does not have the same meaning as socialized medicine as it is used in the US. There is the phrase in French "la médecine socialisée" but it is a direct translation of the usage in the US and is used to report on issues in US medicine such as the current US elections and in reviews of the movie Sicko.It is not an example of usage. I see you have have only ever made 2 WP edits and that was to comment in this discussion. Faux-nez? —Preceding unsigned comment added by Hauskalainen (talk • contribs) 18:12, 4 March 2008 (UTC)

order of definitions and who uses them in lead

I have reverted an edit that attempted to switch the order in which the two definitions were presented in the lead, and to characterize who uses the term in those two ways. Here's my reasoning: as noted above, we have been able to find numerous neutral sources (dictionaries and other encyclopedias) that define the term in its broad sense. For that reason, I think the broad definition should come first, and should not be characterized as biased usage ("pressure groups and the political right"). The narrower term may be the more accurate one used by health economists and policymakers, but that assertion was unsourced in the edit, and citing one such individual (Reinhardt), no matter how well-respected, seems a little weak to me. Can we leave those fine points to the "Current usage" section? --Sfmammamia (talk) 14:09, 10 March 2008 (UTC)

There are other citations which can be moved up that support both the narrow and the pejorative. It is well-supported by sources.--Gregalton (talk) 07:54, 14 March 2008 (UTC)
No doubt, but that was not the nature of the edit as first presented. --Sfmammamia (talk) 14:23, 14 March 2008 (UTC)
I'm not sure about the edit in question. The usage, however (no comment on the specific terminology as above) is clear and documented. As for the citations provided, there was a period way back when during which citations were requested, subsequently provided, and then moved down into lower sections (for reasons that were never clear). Likewise, the "usage" section keeps getting moved down below "implementations". While there is certainly no consensus, there seem to be a number of editors that support keeping it higher up. And a broader point: if the definition is either broad or narrow, and hence applied to an inconsistent group of "implementations", it would seem to me odd to put implementations higher than usage. Best,--Gregalton (talk) 16:04, 14 March 2008 (UTC)
Here's the diff that started this discussion. The change implied two points: 1. that the broad definition is the one most commonly used by opponents of public health care -- in other words, the ones most likely to use the term pejoratively, and 2. that the narrow definition is the one most used by health economists and policymakers. While these points may be true, they need to be pretty strongly supported by references within the lead itself. I just didn't see that done in the edit in question. Is that doable? Also, at the risk of repeating myself, I agree that the usage section should precede implementations in the body of the article. --Sfmammamia (talk) 17:36, 14 March 2008 (UTC)
Fair enough, I believe I misunderstood your point.--Gregalton (talk) 19:19, 14 March 2008 (UTC)
What? A lack of clarity; on THIS talk page? Shocking! ;-) --Sfmammamia (talk) 22:08, 14 March 2008 (UTC)


The term is used often pejoratively...

The claim that socialized medicine is a pejorative term is made by left-wing sources and is POV. It should be moved from the lead to some other section and there it should be noted that it is a lef-wing claim. --Doopdoop (talk) 22:39, 14 March 2008 (UTC)

Doopdoop, I appreciate the attempt at discussion, but have you reviewed all 80 Google Books references? What about the book I just added as a ref? What evidence do you have for your assertion that all are left-wing sources? --Sfmammamia (talk) 22:47, 14 March 2008 (UTC)
Which book is written by the oponent of the Socialized medicine? --Doopdoop (talk) 22:50, 14 March 2008 (UTC)
As noted in the edit summary, a simple seach on Google Books for the phrase "socialized medicine and pejorative" yielded 80 references. The reference I added, by Mark Rushefsky and Kant Patel, shows no evidence of being a left-wing screed. It's a well-regarded book, in its third edition, that has earned positive reviews in the New England Journal of Medicine and other respected publications [1]. There are numerous other references supporting the statement that the term is used pejoratively. Unless you can demonstrate that ALL sources who state that the term is a pejorative are biased (or find a reliable source who so states your assertion), the weight of evidence is against your assertion. Remember, the standard is verifiability. The statement in the article has been more than adequately verified. --Sfmammamia (talk) 23:51, 14 March 2008 (UTC)
One standard is verifiability, and I am sure Kborer has many verifiable Rothbardian statements to put into lead. Another good standard is NPOV, and here we have in the lead a piece of left wing bias. Rushefsky and Patel are biased, for example they have criticised stem cell research funding policies of current government, and while I agree with their criticism, I know there are many who don't. --Doopdoop (talk) 22:59, 15 March 2008 (UTC)
Doopdoop, the wording you are insisting on reverting (at least four times in three days) is that the term is "often used as a pejorative". Not "always used" -- "often used". This is well supported, and so far you haven't supplied any evidence supporting your view that ALL sources who so characterize its usage are left-wing biased. To cut to the chase, there is no consensus for your constant revert of this statement, and I urge you to self-revert and work it out here on talk. --Sfmammamia (talk) 00:10, 16 March 2008 (UTC)
Just for additional backup: Paul Burleigh Horton, Gerald R. Leslie, The Sociology of Social Problems, 1965, page 59 (cited as an example of a standard propaganda device). Quite literally a textbook example (this has been referred to as one of the few sociology textbooks to be reprinted more than ten times over a period approaching fifty years) of "name-calling". Could this be considered, specific support of pejorative usage?--Gregalton (talk) 07:58, 15 March 2008 (UTC)
Thanks Gregalton. It's just the ticket... And its age is such that it has a considerable pedigree and not tied to recent debates. —Preceding unsigned comment added by Hauskalainen (talk • contribs) 02:58, 15 March 2008,

WP:UNDUE requires that article should fairly represent all significant viewpoints. If we add a view that term is "often used as a pejorative", we should also add a view that "some argue there is much in healthcare socializm everywere that mirrors the former Soviet experience" [2]. I would prefere moving these two viewpoints from the lead to appropriate sections below. --Doopdoop (talk) 14:53, 16 March 2008 (UTC)

Seems to me, your additional statement represents the SAME POV, not a different one. "Socialized medicine=bad." --Sfmammamia (talk) 17:50, 16 March 2008 (UTC)
If so, let's replace it. --Doopdoop (talk) 18:01, 16 March 2008 (UTC)
Why would we do that? The current statement is much broader, shorter, and more broadly sourced. I can only suggest that your addition be used as an example of the first sentence in the third paragraph of the lead: "The term is often used in the U.S. to evoke negative sentiment toward public control of the health care system by associating it with socialism, which has negative connotations in American political culture". The cite could be added as a source in the lead and expanded upon in the usage section. --Sfmammamia (talk) 18:36, 16 March 2008 (UTC)
Then I'll try to incorporate this [3] briefly in the lead. --Doopdoop (talk) 19:16, 16 March 2008 (UTC)

Disadvantages of socialism

I've modified Doopdoop's version that read: "The term is often used in the U.S. to evoke negative sentiment toward public control of the health care system by those who argue that disadvantages of socialism apply to socialized medicine, thus making an association with socialism, which has negative connotations in American political culture."
The citations here made no such point, so I've returned the original text but added the sentence: "Some argue that the disadvantages of socialism apply to socialized medicine." With a citation flag.
As noted in the edit line, the citations say no such thing, but presumably a citation from a reliable source can be found that does. (Or we could just add Giuliani's line and say it's "European". That should be clear enough :))--Gregalton (talk) 07:09, 18 March 2008 (UTC)
I originally reverted it because it seems to me, having read so much about this subject over the past year, that the connection between "socialized medicine" as a term of abuse in the U.S. has mostly used a different process and has not drawn to the connection to socialism (which was always rather weak given that the world's largest communist country China does not have universal socialized medicine whereas that many capitalist countries such as the UK and Spain do). It has usually been left to the reader or listener to conclude that he or she should belong on one particular side of the argument on the basis of the negative associations set up by the context in which it used. This is why there are so many identical blogs plastered over the web and articles planted in the press about this topic of socialized medicine with so many lies and unsubstantiated horror stories associated with them. Even the so called "Think Tanks" and "Policy Institutes" such Cato, The Centre for Policy Analysis, The Manhattan Institute and others revert to using distortions based on the misuse of statistics and citing shock-horror news stories from the tabloid press (and others) and regarding these as indicative of some norm. The point is not to argue the matter from rational analysis of the situation but to set up negative associations with the word through fear. See the article Culture of fear for more of this. The same technique has been used in recent times to make even the rather positive words "DEMOCRAT" and "LIBERAL" are made to be dirty words by the way that opinionated talk radio hosts spit the word out with disgust and to associate religiosity with being right wing (subtly leaving one to believe that being left wing is somehow Godless). Sure, there are those who explicitly argue the socialized medicine conection with socialism (as Giulliani did) but this is not the norm, and that point it is already covered in the article. And I would argue that the same negative association set-up is what editors here like Freedomwarrior and Kborer did when they were all the time using Wikilinks to highlight words to trigger negative feelings in the U.S. reader... words such as socialism, taxation, government, and even control, as if such words needed explanation. That too was POV pushing of a subtle nature. I wonder how Doopdoop would react if I added a contra argument to the header that countries adopt socialized medicine because of the advantages of socialism and left that unexplained? He would certainly think that was POV! The WP article should not revert to these techniques but give a neutral look at the topic and true facts supported by statistics from neutral and fact-checked sources.--Tom (talk) 08:05, 18 March 2008 (UTC)

Please take a look at a preceding section. If we want a NPOV lead, it should either contain no POVs (including pejorative claim), or it should have balancing POVs. For now I'll try to remove all POVs from the lead. --Doopdoop (talk) 22:58, 18 March 2008 (UTC)

You have not established that this is POV at all. There are numerous sources, which appear to be balanced. Saying it is POV does not make it so.--Gregalton (talk) 07:24, 19 March 2008 (UTC)
I agree wholeheartedly with Gregalton. This has not been established at all. You have to be blind to fail to see how the term socialized medicine is used and which groups use it and which groups do not to see that it is nearly always being used pejoratively. Given this reality the claim cannot be POV.--Tom (talk) 08:50, 19 March 2008 (UTC)
When I wrote "WP:UNDUE requires that article should fairly represent all significant viewpoints. If we add a view that term is "often used as a pejorative", we should also add a view that "some argue there is much in healthcare socializm everywere that mirrors the former Soviet experience" [6]. I would prefere moving these two viewpoints from the lead to appropriate sections below." Sfmammamia replied "Seems to me, your additional statement represents the SAME POV, not a different one.". So both are POVS. --Doopdoop (talk) 20:49, 19 March 2008 (UTC)
Neutral POV is not the same as NO POV -- it is fairly representing all significant viewpoints. My point was that the usage of the term as a pejorative is well-documented and represents a significant viewpoint, and that the quote you wished to add was more a demonstration of pejorative usage than a reflection of a different viewpoint. Please do not use my words to make a point opposite to the one I was making. --Sfmammamia (talk) 22:24, 19 March 2008 (UTC)
What's wrong with adding such a demonstration of a usage to the lead? --Doopdoop (talk) 22:37, 19 March 2008 (UTC)
I will make a bold edit to demonstrate how I think this could be handled neutrally, but allow me to express a lack of confidence that my approach will satisfy consensus. --Sfmammamia (talk) 23:34, 19 March 2008 (UTC)
Your edit has restored NPOV. Do you agree that this ("Some argue that the disadvantages of socialism apply to socialized medicine") is a fair summary of Rockwell article? Also, if you know a more mainstream source that can replace Rockwell please use it. --Doopdoop (talk) 23:51, 20 March 2008 (UTC)
Argue? The article makes claims but does not substantiate them with factual data (see next section in this discussion). I do not think that is argument. For example it claims that Free markets always allocate resources efficiently. But that case is actually hard to make in the case of health. MRI investment is often held up by socialized medicine's critics to be a prime example of efficient free market investment delivering in the U.S. compared to low investment in countries with centally planned systems. The truth is that free market providers in the U.S. have over invested in MRI technology. The over investment caused the cost of MRI scans in the U.S. to be much higher because the equipment and the trained staff to run them are not used efficiently. An article in Imaging Economics magazine stated that "the key to MRI financial viability is now volume, volume, volume. But how can MRI facility managers conjure up the additional patients to meet their costs?" The response to this was for the U.S. scanning industry to call for more referals from the medical profession to keep the surplus equipment in profitable use. See http://www.imagingeconomics.com/issues/articles/2001-05_03.asp. And it seems to have done so because the U.S. performs more of these expensive scans per capita than almost any other country apart from Japan. As a result there are probably more unnecessary scans being done in the U.S. and they are also on average more expensive than in other countries. A case of the tail wagging the dog if ever there was one.
The UK has much more central planning in health matters than, say the U.S. which, if the argument that free markets deliver more and more cheaply was true, should mean that health care in the U.S. would be both cheaper and more widely available in the U.S. than it is in the U.K. But clearly all the main statistics seem to show the reverse to be true. -Tom (talk) 10:06, 21 March 2008 (UTC)

Mises article

The Mises article is a good example of how policy institutes bend the truth and tell lie lies.

The title of this artice is Socialized Medicine in a Wealthy Country. I think we can take it from the discussions in the article that it is talking about the U.S. As the WP article makes clear, the examples of socialized medicine in the U.S. are systems such as the Military and Veterens health care services and that set up for native (indian) americans. But the Mises article chooses to ignore these examples completely.

Instead it begins by discussing what happpened in the Soviet Union and makes the claim that "A similar experience was repeated in every socialized state. Health declined." But it gives no evidence of this. The reader is just invited to believe the statement is factual.

Later we get another claim.

This (regulation and taxation on the assumption that health-care provision cannot be left to the market alone in former socialist countries) is despite the vast number of stories we hear about English and Canadian health care socialism, mostly having to do with a lack of innovation and a grim shortage of medical, surgical, and emergency services. In these countries, there is much that mirrors the former Soviet experience, except in one area: their governments are not as poor.

(My highlighting)

So here again is another statement, so blazingly obvious to the author that it does not need actual proof. A grim shortage of medical, surgical, and emgergency services? Lack of innovation? Much that mirrors the former Soviet experience? Where is the evidence for this claim? This is just a complete lie wrapped up and sold as as fact. Readers with no experience of the English or Canadian health care systems are likely to believe such nonsense because most will of course have no personal experience of it to be able to challenge it. And yes the right wing blogs in the US are very fond of quoting new stories from the UK and Canada but such stories are often with very little foundation and an example of an incident in one hospital say, just cannot lead one to make conclusions about a nation's health care system.

I despair at the ways the American public are lied to about this subject every day. And I despair that we have to include links to biased, non-fact checked articles in encyclopedia that is supposed to be well referenced. (And before anone reminds me, yes of course, I do realize that this reference was included as an example of guilt by association).--Tom (talk) 09:46, 20 March 2008 (UTC)

It would be very interesting to hear Kborer's reply to your comment. I think he might be a fan of Mises institute. --Doopdoop (talk) 23:46, 20 March 2008 (UTC)

Support and criticism sections

Both of these sections have been tagged for awhile, becauase they do not follow the preferred structure for a Wikipedia article. Namely, support and criticism should not be isolated in their own sections, they should integrated and organized topically. See Template:Criticism-section. I beleve this suggestion has been raised before, but I haven't seen any effort expended so far in this direction. Perhaps it would be worthwhile to discuss here a possible topical structure that could contain the pros and cons more neutrally. There are also numerous unreferenced statements in these sections -- they really should be tightened up and cited. In my opinion, this would vastly improve this article.

Alternatively, perhaps it's time to resurface another suggestion I have made before here and elsewhere. See this discussion. I have suggested starting an article specific to the debate in the U.S., for example, "Health care reform in the United States", so that the numerous debate sections that seem primarily focused on the debate in the U.S. but appear in several global articles: Universal health care,publicly-funded health care, Health care reform and here, could be consolidated in one place and removed from global articles, where their relevance is questionable. Thoughts about either or both of these suggestions? --Sfmammamia (talk) 20:42, 13 March 2008 (UTC)

I strongly support the first proposal about integrating the criticism section. However I think that arguments presented in the American debates are very important from the global perspective too. --Doopdoop (talk) 23:00, 13 March 2008 (UTC)
Doopdoop, can you please expand on your second point? Why is the US debate important from a global perspective? --Sfmammamia (talk) 23:26, 13 March 2008 (UTC)
Healthcare expenditures in the US make up a large part of global healthcare expenditures. A large part of medical research is performed in the US. Some conservative politicians in the UK use the arguments from socialized medicine debate when they propose various healthcare reforms (for example "patients' passport" plan, the scheme that allows patients to use half the cost of their NHS operation to be treated privately). Debate about the appropriate degree of centralized control of healthcare is also continuing in other countries. --Doopdoop (talk) 23:51, 13 March 2008 (UTC)
The US debate does not add anything to debate in the UK as far as I can tell. Of course, those who choose to pay for private medical care would love the government to help them with their costs on the grounds that they are saving the government money by being treated privately. But because this is a form of queue jumping, all governments (on the right and the left) have always resisted this. There is no widespread support for this idea and it certainly is not an idea coming from the U.S.--Tom (talk) 07:13, 14 March 2008 (UTC)
The idea has considerable suport among Conservative party activists, and the implementation would be a major step towards the US-style decentralization. There is a sharing of healthcare reform ideas between US and UK conservatives. --Doopdoop (talk) 21:23, 14 March 2008 (UTC)
Your evidence for this ("considerable support" and "sharing of hc reform ideas")? I have seen no evidence for this other than a few well funded "think tanks" or "policy groups" which look and sound very much like their American cousins (so much so that one suspects that one is an off-shoot of the other). There is scant information about who is behind them and especially who is financing them. They make a bit of noise but they do not hold the centre ground and have virtually no political influence as far as I can tell. They are certainly not mainstream conservatives.--Tom (talk) 10:55, 15 March 2008 (UTC)

Okay, based on this discussion so far, it sounds like there's perhaps less resistance to reorganizing the debate section in this article than there is to the (hugely ambitious) idea of forking it (from here and other places) into a US-specific article. I volunteer to compile a topic outline that I will post here before undertaking such a reorganization. I'm going to attempt to encourage discussion and comments BEFORE the section undergoes major refactoring, so perhaps we can avoid another slow-motion edit war on yet another section of this article. --Sfmammamia (talk) 22:23, 14 March 2008 (UTC)

I think social justice concerns, level of innovation, and cost vs. quality should be the top three topics. --Doopdoop (talk) 22:43, 14 March 2008 (UTC)

See below for my attempted outline. Suggested changes or additions are welcome. Looks like this could be done in three main sections, although further breakout may be possible. A: represents supporters of public systems, B: represents opponents.

Health care as a market A: benefits of eliminating profit motives, avoiding overproduction, administrative simplicity B: third-party payment incentivizes over-consumption (moral hazard argument), leads to wait times and other forms of rationing, market incentives lead to efficiency and innovation, governments never as efficient as private sector, regulation imposes extra costs

Access, equality A: benefits of preventive care versus delayed, expensive treatments; economic benefits of healthy populace; broad pooling eliminates adverse selection problems, human rights argument B: requiring health insurance limits personal freedom and choice, requires higher taxes, universal systems also limit access, adequate government funding is not sustainable as populations age

Outcomes Debate over what constitutes quality, how value for money decisions are made in private vs public systems, how difficult it is to measure system effectiveness, difficulty of drawing conclusions from international comparisons

I will leave this up for discussion a few days and perhaps tackle the actual edit this weekend. --Sfmammamia (talk) 14:45, 19 March 2008 (UTC)

I think the structure is good, although I remain concerned that this duplicates info in public health care, et al. But I'll think on this. One suggestion is that much of the topic areas could be covered broadly and piped to main article health economics (which also needs some work and should possibly be renamed health care economics). Thanks for the constructive suggestion.--Gregalton (talk) 15:15, 19 March 2008 (UTC)
Sfmammamia's proposal preserves grouping the arguments into the groups by POV and so does not really solve the Template:Criticism-section problem. --Doopdoop (talk) 22:45, 19 March 2008 (UTC)
I don't intend to label arguments as pros and cons, and other than that, I can't see anything in Template:Criticism-section that says you can't group arguments logically. The As and Bs in the outline above are just to make it easier to see what topics from the existing section go where. I think neutral presentation can be achieved by presenting the arguments in neutral language. Perhaps the best way to see if this is valid will be for me to undertake the edit and post it on a subpage of my userpage for anyone to look at ahead of making the overall edit. If you have other constructive structural suggestions, I'm open to them.--Sfmammamia (talk) 23:30, 19 March 2008 (UTC)
I think it should be determined which items from the long list of topics you gave are most important for the supporters and opponents of socialized medicine. Then for each topic prominent views from both sides should be presented. Neutral language is not required if two opposing viewpoints about a topic are presented one after another. In my opinion social justice concerns, level of innovation, cost and quality should be the top four topics (not necessary in that order) but of course I'm open to other suggestions.--Doopdoop (talk) 22:37, 22 March 2008 (UTC)

I broadly support the development of a text which is less focussed on the US debate and more focused on factual information rather than claims that are unsubstantiated or based on rather flimsy evidence (such as tabloid news articles, blogs). I agree that topics should be grouped together. I disagree entirely with the suggestion above that neutral language is not required and I suspect that sequencing is again going to be controversial because there will be those editors who wish to influence the debate and put their issues to the fore rather than the prime reasons why countries that have socialized medicine have chosen to adopt that model (which to my mind seems to be the logical set of issues to be discussed first). The success or otherwise of this and any unforseen negative consequences, if any, should follow on. This would make the article flow better and give it a more logical view to the reader.

I do think that we will have a problem when we come to the claims of the various pressure groups. I am thinking of claims such as the outrageous one made by one pressure group that under provision of hospital care led to the deaths of thousands in France during a heatwave. (The issue here was there was a heatwave in France and hospitals came under pressure. Many people did die in the heatwave, but lack of medical facilities was not the cause of the high number of deaths). We should avoid repeating such claims just because they are made, and I would argue that we should even avoid leading readers to such articles without warning them first that the claims made in those articles may not be substantiated, even if certain facts in them are (e.g. hospitals did come under pressure and many people did die). --Tom (talk) 09:42, 23 March 2008 (UTC)

Like Greg Alton I want this article to explain the history of the term and somehow not give it more legitimacy. The problem I have that there is no internationally accepted term for socialized medicine in the narrow sense (medical services run by government for an entire population). Public medicine it seems does not mean the same in the US as it does in the UK for example. There should be a place in WP where such systems are explained and their effectiveness´or otherwise is examined. So perhaps Socialized Medicine is as good as a place as any. Which in one sense is why I like Sfmammamia's suggestion about looking at topics. But maybe this could be done by country by topic? After all different countries adopt different ways of doing things and what works in one country may not work in another. The International comparison on expenditure and broad outcomes may have to sit in an international comparisons section. The only thing I would say though is that it should be restricted to socialized medicine in the narrow sense (government adminstered systems) otherwise it will just repeat all the arguments at Publicly-funded health care. There will be plenty of good source material and stats for the UK and I could see what is available in English for Finland. Someone could expand the U.S. section to say more about the Veterans and military health care systems and perhaps that for Native Americans. It should be possible also to get material in English for Israel and perhaps too for other Nordic countries such as Norway. In this way we can stay focussed on facts rather than claims from opininated sources which are often just claims not substantiated by the facts (like the French heatwave claims I mentioned earlier in this thread, or the claim that medicine is more expensive if run by the government because governments don't care and just pass on high costs on as higher taxes). —Preceding unsigned comment added by Hauskalainen (talk • contribs) 01:51, 26 March 2008

Header section (Again)

The lead paragraphs making up the header section should summarize the article as a whole. But we now seem to have 2 items therein which seem to go beyond this. I am proposing that we remove them and move them further down in the article. The two I am refering to are

Most industrialized countries, and many developing countries, operate some form of publicly-funded health care with universal coverage as the goal. According to some sources, the United States is the only wealthy, industrialized nation that does not provide universal health care
This seems to me to have nothing to do with the term "socialized medicine" per se. It could be deleted altogether.

and

Some argue that the disadvantages of socialism apply to socialized medicine. A 2008 poll indicates that Americans are sharply divided in their views on socialized medicine, with a large percentage of Democrats holding favorable views, while a large percentage of Republicans hold unfavorable views.
These are details rather than a summary of the article and therefore they belong lower down.

If no one objects I will move them.--Tom (talk) 22:14, 24 March 2008 (UTC)

I think all of the statements you highlighted as expendable in the lead are critical there for context, because they underscore why there's such a debate on this topic in the United States and how usage of the term "socialized medicine" fits into that debate. With a full third of the article devoted to the support and criticisms of systems that fall under the "socialized medicine" rubric, I think such statements help the reader understand in short form why it is such a contentious topic. I say keep them both. There's already a lengthier treatment of the poll results in the article, so the summary statement in the lead about the poll results is perfectly legitimate material. I thought we had achieved consensus on the sentence "Some argue that the disadvantages of socialism apply to socialized medicine." So I hope we don't reopen the debate on that one. --Sfmammamia (talk) 01:18, 25 March 2008 (UTC)

support / criticisms

I see that Doopdoop has merged support and criticms into one sub and has started a lead paragraph to this new section. If we are not careful, we are likely to end up repeating in the lead paragraph all the arguments in the subsequent lists. Although I have edited this new lead paragraph myself, I feel that we are on a slippery slope here. I would like to revert the article to a list of pros and cons and let the reader decide for him or herself what to think about each. I therefore propose that we revert to the situation prior to this change by Doopdoop. Comments please.--Tom (talk) 22:49, 24 March 2008 (UTC)

I started a discussion earlier on the talk page with suggestions about refactoring the entire support/criticisms section, because I believe the current section structure is not in keeping with Wikipedia's recommendations. Now I'm considering withdrawing the offer to refactor as I have proposed, as I'm getting the sense that it's unlikely to get support from either of the two editing factions on this article. At the risk of repeating myself, the section as written goes against Wikipedia's recommended style. See Wikipedia:Words_to_avoid#Article_structure and WP:CRIT. I've made my suggestion. If any more intrepid editor would like to undertake it, be my guest. If you'd like me to change my mind on this, you know where to reach me. --Sfmammamia (talk) 01:32, 25 March 2008 (UTC)

It is very important to follow guidelines from Wikipedia:Words_to_avoid#Article_structure and WP:CRIT. Current article structure encourages extremist viewpoints and there is no place for serious research findings, such as "Using data on expenditures and life expectancy by income quintile from the Canadian health care system, I find that universal, publicly-funded health insurance is modestly redistributive." and "Using data across the OECD, I find that almost all financing choices are compatible with efficiency in the delivery of health care, and that there has been no consistent and systematic relationship between financing and cost containment.", that were presented in [4]. --Doopdoop (talk) 14:08, 25 March 2008 (UTC)

I'm torn on this one. I repeat my overall opinion - as before - that since the term doesn't have much meaning, the bulk of support/criticisms end up being things that should be covered in other articles. So I'm leaning to getting rid of this entire section unless demonstrably specific to socialized medicine (same with implementations). I think a few other editors share that viewpoint, but I'm not trying to push it.
My comment for the time being is that support/criticisms should be explicit about whether the pro/con is specific to socialized medicine, or to universal health care, or to publicly-funded health care, or simply "government involvement." Most of the points made seem to refer to things that are not specific to socialized medicine (in the narrow sense) and most of the sources (at least support) never refer to socialized medicine at all. I don't think the article should attribute support for "socialized medicine" where the sources do not: if the source supports universal health care, that's what it supports.
In this view, and I'm being open, this article should be mostly restricted to use of the term. Finding an NPOV balance while retaining the uses of the term by the sources may simply be unworkable. But grateful views.--Gregalton (talk) 15:38, 25 March 2008 (UTC)
Most pro/cons are equally applicable to socialized medicine (in a wide sense), to universal health care, and to publicly-funded health care. I always wonder why there are so many different articles in WP about essentially the same topic. --Doopdoop (talk) 21:27, 25 March 2008 (UTC)
Agree that they can apply if the broadest definitions possible are used, but those terms are not pejoratives. To say that people support "socialized medicine" when they have said no such thing and may not agree with the terminology or association, and when the subject can be treated neutrally on the other pages makes the problem worse, not better.--Gregalton (talk) 08:29, 26 March 2008 (UTC)

2008 U.S. Presidential election

The section does NOT belong in the article. It is way too US-centric, suffers from recentism, and way too specific for the general article. Please incorporate the material to US-specific article(s). Renata (talk) 15:13, 25 March 2008 (UTC)

Per earlier discussion, to me and at least one other regular editor here, this example has value in demonstrating the politicized, pejorative usage of the term. Accordingly, I have moved the section to become a subtopic under current usage and have further pruned it. --Sfmammamia (talk) 21:42, 26 March 2008 (UTC)

Health Economics: Balancing Social, Moral, Ethical and Economic Dimensions

I think we owe some thanks to Gregalton. The reference he provided for market failure at http://www.oheschools.org/ohe.pdf is actually a very valuable find, and not just for the small piece on market failure. I just read the whole thing and it does manage to sum up many of the complex social, ethical, moral, financial and economic issues about health economics and delivery in layman's terms (suitable for the audience of teenage school kids at which it is aimed). And it is fairly neutral and unbiased in it presentation of the issues (at least as I read it). I'm wondering if we can make better use of that reference. Perhaps in the United Kingdom section? Or should it get more prominance? It is written in a way that not assume too much prior knowledge of the UK system and does explain some things quite well- The Teacher/Pupil discussion questions at the end of each section are somewhat geared to its UK audience. --Tom (talk) 09:29, 28 March 2008 (UTC)

auto-archive

I am going to be bold and set up an auto-archiver - this page is now so long...--Gregalton (talk) 07:53, 19 February 2008 (UTC)

Gregalton, may I suggest that we slow down the auto-archiver at this point? I think once every 60 to 90 days would be fast enough. Thanks for taking this on! --Sfmammamia (talk) 02:02, 29 February 2008 (UTC)
Will do. Note that I set it so frequent only because the page is so active - right now it is at 190k, 250k may be a point (I understand) where some browsers have issues. If you agree, I'll set it to 50days and see how it works.--Gregalton (talk) 06:06, 29 February 2008 (UTC)
I'm tweaking to 40days before archiving - page is getting long again due to activity. Messages here if there are complaints about this.--Gregalton (talk) 07:16, 4 March 2008 (UTC)
I'm tweaking again to 60days - not now as long as it had been getting. We shall see.--Gregalton (talk) 07:46, 12 April 2008 (UTC)

CLAIMS versus FACTS

I am worried that the support and criticism section is now mentioning claims and not staying focussed on facts. Anyone can claim anything and it may or may not be substantiated by incontravertible data. I think we should stay focussed on factual data. If a claim is made, the foundation for that claim should be examined. For example, the section says that proponents claim government involvement will increase quality and that opponents says it will reduce quality. What is the reader to make of all this? If are going to allow such claims and counter claims we must at least to try to understand the evidence for such claims and counterclaim.--Tom (talk) 00:20, 29 March 2008 (UTC)

WP:V and WP:ASF allows sourced facts about opinions. Also sometimes claims have factual basis, sometimes claims have a more theoretical justifications. Details about such claims (including factual and theoretical justifications) should be added in separate sections below (see the Costs section for an example). --Doopdoop (talk) 00:31, 29 March 2008 (UTC)
I think if an opinion is based on some facts or a well founded theory then that is OK. If an opinion is based on prejudice and not substantiated by factual data then it really has no place in WP unless it is very widely held. The article you added by Sherry A. Glied is full of assumptions that she does not even try to substantiate. Its based on several premises which may or may not be true. I therefore regard even that article as suspect as a source. --Tom (talk) 08:35, 2 April 2008 (UTC)
IMHO Sherry A. Glied paper is a good example of research that is based on facts and appropriate statistical techniques. --Doopdoop (talk) 20:43, 2 April 2008 (UTC)
I'd have liked to give you some examples but the paper has now become pay-per-view and I'll not waste my money paying to download it. . . . but an example was that it just assumed that free market maximised efficiency in the allocation of resources. The assumption was implicit throughout. But as we have seen in many examples in this and many other articles, this is an assumption that is not always true. From another perspective it also values people (or rather the wealth or insurance they have or may not have access to) as commodities. In practice, a low income mother with 4 children is likely to be every bit as valuable to her children and husband and perhaps to the rest of society as a similar mother with a higher income is to her loved ones. A free market health system does not recognize this very important value. --Tom (talk) 02:06, 3 April 2008 (UTC)
I really don't want to get into a wrestling match over this one, but I would point out that the vast majority of economic research is of necessity based on at least some theoretical and methodological assumptions. Those assumptions can, of course, be be challenged and perhaps even refuted. But Dr. Glied is hardly the first economist to publish research based on a particular set of economic assumptions. You might want to look at her CV. She's a well known, well-qualified economist. This particular work may be flawed - if so, let's find another source that explains why and how. But Dr. Glied's too serious an academic for us to reject her work out of hand. EastTN (talk) 14:39, 3 April 2008 (UTC)
I agree - this is too important a paper to throw into doubt based on criticism (but I haven't read it yet). That said, Tom, you're mixing up two different points (both standard in economics): 1) when there are significant market failures and externalities, maximum efficiency may not be achieved from simple free market (and of course, full free market in health care is probably only in failed states anyway); 2) efficiency does not tell you much about distributional equity (however one might wish to call it). The latter is a choice of the political system. (And there's a complex meta-argument about whether some degree of distributional equity has positive externalities on a societal level). (Okay, there's about thirty levels of complex meta-arguments)--Gregalton (talk) 15:10, 3 April 2008 (UTC)
Please note that Dr. Glied specifically analyzed various funding schemes in terms of distributional equity and has found that they have only limited impact - i.e. the subject of the paper is your second question. The first question (efficiency) was also analyzed in the same paper, and the paper found "Using data across the OECD, I find that almost all financing choices are compatible with efficiency in the delivery of health care". --Doopdoop (talk) 21:30, 3 April 2008 (UTC)
This is only partly on-topic: I am skimming the paper quickly, but I can find no reference to socialized medicine at all in Glied's paper.--Gregalton (talk) 14:09, 9 April 2008 (UTC)
I urge anyone interested to read the paper. It has been mostly misrepresented in the discussion above and in most of the press reporting on her article that I have seen - if anything she is advocating for MORE progressivity in health care provision, and she is certainly not advocating "free market" provision of health care - rather a mix of financing. The widely-reported conclusion about financing having not much effect on cost has neglected the conclusion that other aspects of market organisation can and do affect efficiency. "In terms of public financing, the results suggest that forms of revenue collection that tax both older adults and young people are more equitable, over the lifecycle, than those that tax younger people and cover older people. The greatest redistributive benefits of public health financing occur among middle-aged people who become seriously ill or disabled. Differential mortality and relatively equal health status among survivors make public financing of benefits to the elderly less redistributive. In terms of the mix of public and private financing, the potential for public health insurance to crowd out other forms of redistributive benefits, without generating significant redistribution themselves, suggests that a mixed financing system may be the optimal way to balance efficiency and equity in health care."
To sum up, the elderly are taxed less but receive much care (especially in the US), whereas it would be more progressive to provide more health insurance to the middle aged (young people need less health care, old people - due to survivor bias according to wealth - tend to be wealthier, and hence burden of lack of health insurance falls on the poor middle-aged). The widely-reported conclusion that Canada's health care system is "not very progressive" is a gross simplification - it is less progressive than it should be / could be, partly because it provides fairly high-end care to the elderly with little taxation, and the elderly represent those that were wealthy enough to live longer. (This ignores the question of the political system, which - since Medicare for the elderly in the US is strongly associated with Social Security - played a key role in how the system was structured. As Krugman and others have pointed out, the Medicare system for the elderly was a political trade-off - provide universality for some of the population to keep political support. Likewise universality in Canada and elsewhere.)
The conclusion on financing leaves out the part that "the efficiency of operation of the health care system itself appears to depend much more on how providers are paid and how the delivery of care is organized than on the method used to raise the funds." This does not necessarily contradict any part of "socialized medicine" or government involvement, either directly or through regulation. Her point is that the "technical efficiency depends on the systems used to pay providers." She also has a number of caveats to this point about financing: "There are many reasons that this happy outcome may not occur in the health care system and the market may bid prices up too high. Provider monopoly power or other related payment inefficiencies, however, do not affect the choice of financing system. Payment rates may also, in theory, be established independent of the form of financing, although this may be practically difficult to achieve. For example, by using regulation, systems with decentralized revenue collection can achieve the same monopsony payment rates that centralized payment systems can." In other words, government regulation may still be needed to achieve efficiency due to market failures.
She fairly succinctly and completely throws into question how private insurance may work in practice (even if theoretically possible to do efficiently): "In practice, the existence of employer-sponsored insurance, the preferential tax treatment of premiums, and the existence of substantial risk selection between plans may make it more difficult for private insurance systems to achieve efficiency in the delivery of services."
Finally, on costs, she also obliquely refers to the progressivity of "innovation": "These patterns suggest that focusing the marginal public health care dollar on skilled nursing days, access to general practitioners, and care associated with conditions that manifest in mid-life will have a more progressive effect than focusing additional tax dollars on elective surgical procedures or specialist care." In other words, using tax dollars for high-cost, "innovative" procedures that benefit the wealthy may be net regressive.
She is also fairly clear throughout that the progressivity of the financing system is part and parcel of the progressivity/equity of the tax system, which is worthy of further consideration.--Gregalton (talk) 15:32, 9 April 2008 (UTC)

Innovation section

Forgive me for asking, but what does the new innovation section tell us about socialized medicine? --Tom (talk) 08:26, 2 April 2008 (UTC)

The NY Times article is also rather inaccurate. MRI is attributed as a US innovation, but the application of NMR to MRI was as much a British discovery as an American one. I know this because my own teacher of physics in the 1970's was himself a student under a professor at Nottingham university (who I guess must have been Peter Mansfield) who washugely influential in this work and I can vivdly recall my teacher's excitement of himself being close to what seemed to be such a huge step forward. Mansfield shared the Nobel prize with an American for this work. The earlier Nobel prize for NMR discoveries were shared by a European and an American. Even more startling is that the CT scanner is also credited as an American innovation, but the first CT scanner was in fact developed in the UK by a British company! Come on!!! --Tom (talk) 08:56, 2 April 2008 (UTC)

It gets worse!! The article states that "in the last 10 years...12 Nobel Prizes in medicine have gone to American-born scientists working in the United States, 3 have gone to foreign-born scientists working in the United States, and just 7 have gone to researchers outside the country". Looking at Nobel Prize in Physiology or Medicine in the last 10 years shown (1998-2007) I see that the United States (Population 304 million) has 16 accreditations and the United Kingdom (population of 62 million) has 7 accreditations. In other words, even a cursory glance at some real facts reveals that a country (which happens to have socialized medicine) achieves about double the rate of Nobel prizes than one which mostly does not. Now I would not have the audacity to argue that the form of medicine delivery in the UK has any connection to this amazing achievement, but trying to use the socialized medicine article to argue that socialized medicine fails to deliver innovation and Nobel prizes is pulling my nose way beyond that which I can bear. I think this entire section is without merit.--Tom (talk) 09:26, 2 April 2008 (UTC)

The Innovation section adds nothing to this article, other than a reference to one opinion piece by one American academic. Notable perhaps, as a supporter of the current American system, but hardly meriting a section of its own in this article. The cited article doesn't make any mention "socialized medicine", yet is being used an argument against it by a Wikipedia editor, not the article itself. It is also very hard to present a balanced viewpoint of the argument, unless someone else can produce a notable cite for the other side. As Tom notes above, the argument has significant flaws, but unfortunately his figures would be considered original synthesis. So I'd say unless the whole argument can produce at least three more cites of greater relevance, at least one opposing, it should be removed. Or at the very least abridged and placed deep in the Criticisms section where it belongs. --Escape Orbit (Talk) 10:33, 2 April 2008 (UTC)
Krugman and Wells have already dealt with this. ""new medical technology" is the major factor in rising spending: we spend more on medicine because there's more that medicine can do. Third, in medical care, "technological advances have generally raised costs rather than lowered them": although new technology surely produces cost savings in medicine, as elsewhere, the additional spending that takes place as a result of the expansion of medical possibilities outweighs those savings." There's much more detail, but in simplistic terms, innovation doesn't lead to that many lives saved if people can't access it: "one study found that among Americans diagnosed with colorectal cancer, those without insurance were 70 percent more likely than those with insurance to die over the next three years." (Not that treatment of colorectal cancer is so very innovative). In terms of effectiveness in saving lives, hand-washing by doctors and nurses is one of the most cost-effective measures; unfortunately, the soap lobby is insufficiently incentivized. Another interesting study recently was that use of "innovative" (expensive) drugs in Canada tends to be far lower than in the US - not because of cost (drugs in use were studied), but because advertising severely restricted. (Note that as I recall, the health outcomes were no worse).
But as above, the Cowen quote does not appear to mention socialized medicine.--Gregalton (talk) 11:09, 2 April 2008 (UTC)
Mark Thoma (Dept of Econ, U. of Oregon) also has some good analysis: [5]. The best point I read on Cowen's piece being "changing the yardsticks": apparently the goal is no longer to improve health but to win research prizes. Perhaps an obvious choice for a university department, not so obvious for society as a whole. (No data provided on actual results of innovation, except for the same data showing ... high spending for poor results).--Gregalton (talk) 11:19, 2 April 2008 (UTC)
Thanks for the Krugman and Wells article. Interesting stuff. It mentions Taiwan and a move to Single payer there. Not something for this article but perhaps something that should be in Single-payer health care. I don't have the time to add it but perhaps User:Doopdoop does ;) (TFIC).

Based on the comments here, and a re-look at the source, I have deleted the section. As noted, there is little to no connection to socialized medicine made in the source, and its comparative claims appear to be inaccurate and unsubstantiated. The section was built, essentially, on one economist's opinion. --Sfmammamia (talk) 16:46, 2 April 2008 (UTC)

One other comment -- this paragraph has also been added to Health care reform in the United States, where it seems more relevant to me. --Sfmammamia (talk) 16:48, 2 April 2008 (UTC)

As Escape Orbit requested, I have added three more cites. --Doopdoop (talk) 20:56, 7 April 2008 (UTC)

As far as I can tell, none of these citations meet any of the points made by EscapeOrbit: they do not mention socialized medicine, and appear to be opinion pieces. Unless there's a compelling reason to keep this in this article (as opposed to some other article), I'll delete later.
Note that the sentence "The Cato Institute argues that socialized medicine would stifle lifesaving research and innovation" is blatant misrepresentation of the article cited (the Cato institute may argue this elsewhere, but this article does not). I'm deleting this immediately because of this.
As a final comment on this section, I'd note that the Cato article makes much of the use of "differing datasets" in the WHO report - while this same standard applied to the Cowen article would result in simple rejection as absurd simplification (NHI spending on research vs "All EU core countries" spending - are these even remotely comparable?).--Gregalton (talk) 06:25, 8 April 2008 (UTC)

I see that the innovation section has been reinstated. I fail to understand why. It does not once mention Socialized Medicine and does not even try to explain why its content is relevent to this article. A connection has not been established. Socialized medicine is about the delivery and financing of health care. Medical innovation is only tangentially connected to this. Also, the comparisons in the article and references are to "Europe" verses the "USA" which does not really map to "socialized medicine" versus "non socialized medicine" (if such a pure comparison could even be made because no country is purely one or the other). One might well be tempted to conclude that the reason so much money is invested in the US is merely that is where so much money is being spent (and where, it seems, there are few value-for money type controls in the US as for example is done in the UK by the National Institute for Clinical Excellence"). But that is pure speculation on my part.--Tom (talk) 09:06, 8 April 2008 (UTC)

As socialized medicine has many synonyms, it is sometimes refered to by other names in the sources, for example CATO piece that Gregalton deleted contrasts free-market medicine with "WHO's idea of government-provided universal health care", so the sentence that Gregalton deleted is a fair summary of what was written in the source, and I would like to restore it. Tom argues that medical innovation is only tangentially connected to socialized medicine, however Cowen opposes reforms that promote socialized medicine because they would stifle innovation. --Doopdoop (talk) 18:09, 8 April 2008 (UTC)
This (i.e. "socialized medicine has many synonyms") sounds like your own interpretation. Cowen merely contrasts Europe and the US and makes a broad reference to a European model without actually defining it (-hardly surprising because there is a wide variety of models across Europe, and if he had done so he would trip at the first hurdle). You seem to be doing an awful lot of interpolation to say that "Cowen opposes reforms that promote socialized medicine". That rather makes this your interpretation and therefore WP:OR. Cowen does not addresses socialized medicine at all. He is just argues that the US spends a lot more on medical research than Europe because the US spends more on health care, that there are different attitudes in the US than in Europe towards failure, and that European researchers work in the US because the salaries are higher there. Cutting that expenditure could hit research is the implication, but there is nothing about socialized medicine.
And as we said earlier, he seems to have got his facts wrong about the U.S. system leading to preminance in the 6 most important applied technologies of the last 25 years as well the reading and interpretation of data regarding pure research as measured by Nobel prizes. Britain seems relatively to have done as much even though it has a socialized system. It would be rather difficult to check the absolute numbers regarding expenditure and he seems to have just one source for that data. But I am not inclined to do any checking.
For this reason, and the reason that other editors seemed to agree with my earlier comments about relevance and factual correctness, I am going to delete this again.--Tom (talk) 06:25, 9 April 2008 (UTC)
The Kling summary also seems to gloss over (at least part of) the argument Kling makes in his book (not sure whether the Kling quote was properly used / linked to the book in one of the intermediate versions): "attributing our present cost crisis mainly to the practice of what he calls "premium medicine," which overuses expensive forms of technology that is of marginal or no proven benefit." See New England Journal of Medicine Review. Compare this to the argument that Kling makes as summarized in the article: "Arnold Kling says that America's role in medical innovation is crucial not just for Americans, but for the entire world". I can't compare the article content since not provided.
But at any rate, that whole section is still out of place in socialized medicine article and glad to see it gone (at least until EscapeOrbit's points can be met).--Gregalton (talk) 12:09, 9 April 2008 (UTC)

Please read the first paragraph of Cowen's article. It is refers to "advocates of national health insurance", and national health insurance schemes are covered by socialized medicine article, so innovation section should be restored. --Doopdoop (talk) 22:31, 9 April 2008 (UTC)

That rather depends on what you mean by National Health Insurance and also by Socialized Medicine. As we have seen, the meanings of these words can be very flexible. I don't think you can sit in the author's head and understand precisely what he or she did mean by that.--Tom (talk) 09:03, 12 April 2008 (UTC)